D-dimer, ferritin and C-reactive protein. Value in the stratification of patients with COVID-19
Keywords:
COVID-19, ferritin, D-dimer, C-reactive proteinAbstract
Introduction: The COVID-19 pandemic continues to challenge healthcare systems. The stratification of affected patients from biomarkers, a less invasive strategy, is still controversial.
Objective: To check the discriminating capacity of ferritin, C-reactive protein and D-dimer in patients with moderate and severe COVID-19.
Methods: A cross-sectional design was applied from June to November 2021. The qualitative variables and age were recorded by review of the patient’s clinical records. The determination of the aforementioned biomarkers was carried out at the time of inclusion in the study using the Roche reagents in the HITACHI Cobas C 311 analyzer. The SPSS statistical program was used for analyzing dates.
Results: There was a predominance of hypertensive patients in both groups. Vaccination and female sex prevailed among the moderate ones, while men and chronic diseases among the severe ones. Higher levels of the three analyzed biomarkers were observed in the severe group (Mann-Whitney test p < 0.05). The association between these was significant in both groups (Spearman correlation, p < 0.05). 366 μg/L of ferritin; 36.25 mg/L of C- reactive protein and 1.02 μg/mL of D-dimer, acceptably distinguished between severe and moderate (area under the curve ˃ 0.5; p < 0.05).
Conclusions: The presence of chronic comorbidities and unvaccinated individuals predominated among severe patients. A close correlation was shown between the biomarkers analyzed in both patient groups. Biomarkers showed discriminating capacity between moderate and severe COVID-19 disease.
Downloads
References
2. Worldometer. COVID - Coronavirus Statistics – Worldometer [Internet]. Delaware: Worldometer; 2023 [citado 01/01/2023]. Disponible en: https://www.worldometers.info/coronavirus/
3. Qin C, Zhou L, Zhang S, et al. Dysregulation of Immune response in patients with COVID-19 in Wuhan, China. Clin infect Dis [Internet]. 2020 [citado 01/01/2023];71(15):762-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32161940/
4. Feng X, Li S, Sun Q, et al. Immune Inflammatory Parameters in COVID-19 cases: A systematic Review and Meta-Analysis. Front Med (Lausanne) [Internet]. 2020 [citado 01/01/2023];7:301. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32582743/
5. Bozkurt FT, Tercan M, Patmano G, et al. Can Ferritin Levels Predict the severity of illness in Patients with COVID-19? Cureus [Internet]. 2021 [citado 01/01/2023];13(1):e12832. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899245/
6. Tang N, Li D, Wang X, et al. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost [Internet]. 2020 [citado 01/01/2023];18(4):844-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32073213/
7. Conte G, Cei M, Evangelista I, et al. The Meaning of D Dimer value in COVID-19. Clin Appl Thromb Hemost [Internet]. 2021 [citado 01/01/2023];27:10760296211017668. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142231/
8. Kaushal K, Kaur H, Sarma P, et al. Serum Ferritin as a predictive biomarker in COVID-19. A systematic review, meta-analysis and meta-regression analysis. J Crit Care [Internet]. 2022 [citado 01/01/2023];67:172-81. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34808527/
9. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of coronavirus disease 2019 in China. N Engl J Med [Internet]. 2020 [citado 01/01/2023];382:1708-20. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32109013/
10. Vargas-Vargas M, Cortés-Rojo Cl. Ferritin leves and COVID-19. Rev Panam Salud Pública. 2020;44:e72. DOI: 10.26633/RPSP.2020.72.
11. Kernan KF, Carcillo JA. Hyperferritinemia and Inflammation. Int Immunol [Internet]. 2017 [citado 01/01/2023];29(9):401-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28541437/
12. Ruscitti P, Berardicurti O, Barile A, et al. Severe COVID-19 and related Hyperferritinaemia: more than an innocent bystander? Ann Rheum Dis. 2020;79(11):1515-6. DOI: 10.1136/annrheumdis-2020-217618.
13. Rajendran V, Gopalan S, Varadaraj P, et al. Course of COVID-19 based on Admission D Dimer levels and its influence on Thrombosis and Mortality. J Clin Med Res [Internet]. 2021 [citado 01/01/2023];13(7):403-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336942/
14. Poudel A, Poudel Y, Adhikari A, et al. D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19. PLoS ONE [Internet]. 2021 [citado 01/01/2023];16(8):e0256744. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34437642/
15. Wool GD, Miller JL. The Impact of COVID-19 Disease on Platelets and Coagulation. Pathobiology. 2021;88(1):15-27. DOI: 10.1159/000512007.
Downloads
Published
How to Cite
Issue
Section
License
All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.
It allows:
- Copy and redistribute published material in any medium or format.
- Adapt the content.
This will be done under the following terms:
- Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.
- Non-commercial use.
- Recognize the journal where it is published.
The copyrights of each article are maintained, without restrictions.
Guidelines to authors
